Extended Release Abuse Deterrent Liquid Fill Dosage Form

ABSTRACT

The present disclosure relates to an oral, extended release, abuse deterrent dosage form containing a controlled release agent, a second agent and/or polyethylene glycol, and at least one active pharmaceutical ingredient susceptible to abuse. The dosage form is stable at high temperatures and abuse deterrent to oral and parenteral administration via dose dumping, extraction, and purification. The present disclosure also relates to processes of preparing the dosage form.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application No. 62/066,298 filed Oct. 20, 2014, the disclosure of which is incorporated herein by reference in their entirety.

FIELD OF THE TECHNOLOGY

The present disclosure relates to an oral, extended release, abuse deterrent dosage form. The dosage form contains active pharmaceutical ingredient (API) suspended in a wax matrix which is difficult to extract in order to reduce abuse by non-oral administration routes, e.g. intranasal and/or intravenous. The dosage form also contains a controlled release agent with a relatively low melting temperature, for example, stearoyl polyoxylglyceride and a second agent, for example, polyvinylpyrrolidone (PVP) or a polyethylene glycol (PEG). The low melting temperature allows the controlled release agent to homogenize the API and other excipients within a wax suspension without degrading the API. The composition is designed to allow for extended release of the active ingredient while deterring abuse and maintaining stability of the dosage form at elevated temperatures.

BACKGROUND

FDA-approved drugs are provided in many different forms based on the type of active substance, the indication treated and the preferred route of administration. These forms include enteral formulations (e.g., tablets, capsules or pills), parenteral formulations (e.g., injectable formulations such as intravenous, subcutaneous, intramuscular and intraarticular), liquid formulations (e.g., elixirs), lyophilized formulations and topical formulations. A majority of the FDA-approved drugs are currently available in enteral form, as either a tablet or capsule. Several formulations have been investigated for deterring abuse, either by oral ingestion of the drug with alcohol, or by non-oral administration routes such as intranasal and/or intravenous administration. However a need still exists for extended release abuse deterrent dosage forms.

SUMMARY

The present disclosure relates to an extended release, abuse deterrent capsule including an active substance susceptible to abuse, a controlled release agent, such as a stearoyl polyoxylglyceride, that has a melting temperature less than or equal to about 70° C., and a PEG having an average molecular weight between about 3000 Daltons and about 4000 Daltons or a second agent having a high melting temperature and potentially a high molecular weight, such as a soluble polyvinylpyrrolidone.

The present disclosure also relates to a process for the production of an extended release, abuse deterrent capsule including at least one active substance susceptible to abuse including preparing a homogenized suspension of the at least one active substance susceptible to abuse, a controlled release agent such as a stearoyl polyoxylglyceride that has a melting temperature less than or equal to about 70° C., and a PEG having an average molecular weight between about 3000 Daltons and about 4000 Daltons, or a second agent having a high melting temperature and potentially a high molecular weight, such as a soluble polyvinylpyrrolidone; and dispensing the homogenized suspension into a capsule body to produce the dosage form.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows cross sections of a capsule filling machine including the body segment, the cap disc, the hopper, the pumping box, the substation roller, and capsule bodies.

FIG. 2A shows solutions of grey dye before filtering. FIG. 2B shows solutions of grey dye after filtering.

FIG. 3 shows unfiltered solutions of the dosage forms in 190 proof ethanol after shaking at 250 rpm for 3 hours.

FIG. 4 shows syringe-filtered solutions of the dosage forms in 190 proof ethanol after shaking at 250 rpm for 3 hours.

FIG. 5 shows the difference in dissolution between an intact and ground extended release, abuse deterrent capsule containing 80 mg of active.

FIG. 6 shows the difference in dissolution between an intact and ground extended release, abuse deterrent capsule containing 80 mg of active.

FIG. 7 shows the difference in dissolution between an intact and ground extended release, abuse deterrent capsule containing 10 mg of active.

FIG. 8 shows the difference in dissolution between an intact and ground extended release, abuse deterrent capsule containing 40 mg of active.

DETAILED DESCRIPTION

Abuse of prescription drugs, particularly opioids, is a serious and growing public health concern. To address this concern, new formulations are being developed that contain abuse-deterrent properties. Abuse deterrent properties include properties that make product manipulation more difficult or make abuse of the manipulated product less attractive or rewarding.

Recently the FDA issued a guidance for industry related to formulations having abuse deterrent properties. Guidance for Industry: Abuse Deterrent Opioids—Evaluation and Labeling, U.S. Department of Health and Human Services, FDA, CDER, April 2015, the entire contents of which are incorporated herein by reference. These guidelines separate abuse deterrent formulations into six categories, including: physical/chemical barriers, agonist/antagonist combinations, aversion, delivery system, prodrug, or a combination of the aforementioned. As described by the FDA guidance, the categories are:

Physical/Chemical barriers—Physical barriers can prevent chewing, pulverizing, cutting, grating, or grinding. Chemical barriers can resist extraction of the opioid using common solvents like water, alcohol, or other organic solvents. Physical and chemical barriers can change the physical form of an oral drug rendering it less amenable to abuse.

Agonist/Antagonist combinations—An opioid antagonist can be added to interfere with, reduce, or defeat the euphoria associated with abuse. The antagonist can be sequestered and released only upon manipulation of the product. For example, a drug product may be formulated such that the substance that acts as an antagonist is not clinically active when the product is swallowed but becomes active if the product is crushed and injected or snorted.

Aversion—Substances can be combined to produce an unpleasant effect if the dosage form is manipulated prior to ingestion or a higher dosage than directed is used.

Delivery System (including depot injectable formulations and implants)—Certain drug release designs or the method of drug delivery can offer resistance to abuse. For example, a sustained-release depot injectable formulation that is administered intramuscularly or a subcutaneous implant can be more difficult to manipulate.

Prodrug—A prodrug that lacks opioid activity until transformed in the gastrointestinal tract can be unattractive for intravenous injection or intranasal routes of abuse.

Combination—Two or more of the above methods can be combined to deter abuse.

An opioid analgesic submitted for abuse deterrent formulation (ADF) labeling must show conformance to one or more of these categories. The present disclosure relates to an abuse deterrent dosage form for oral administration, which provides extended release of an active pharmaceutical substance and conforms to one or more of these categories. In one embodiment, the abuse deterrent dosage form of the present disclosure conforms to at least one of the six FDA categories. In another embodiment, the abuse deterrent dosage form of the present disclosure conforms to at least two of the six FDA categories. In another embodiment, the abuse deterrent dosage form of the present disclosure conforms to at least three of the six FDA categories. In another embodiment, the abuse deterrent dosage form of the present disclosure conforms to at least four of the six FDA categories. In another embodiment, the abuse deterrent dosage form of the present disclosure conforms to at least five of the six FDA categories.

For example, an abuse deterrent dosage form of the present disclosure can reduce abuse by the incorporation of at least one barrier, e.g., chemical and/or physical barrier. The barrier can be designed to prevent abuse based on extraction and/or purification of the API from the dosage form. Preferably, the barrier prevents or reduces the effectiveness of these methods. As used herein, the phrase “abuse deterrent” means that the active substance cannot readily be separated from the formulation in a form suitable for abuse by such means as, for example, extraction. Abuse deterrent measures render it difficult to transform the dosage form into a purified, abusable powder or extract for non-oral administration, such as intranasal or intravenous.

In one embodiment, the present disclosure relates to an oral, extended release, abuse deterrent dosage form including (a) an active substance susceptible to abuse; (b) a controlled release agent such as a stearoyl polyoxylglyceride that has a melting temperature less than or equal to about 70° C.; and (c) a second agent having a high molecular weight such as a soluble polyvinylpyrrolidone with a nominal K-value of about 90.

In another embodiment, the present disclosure relates to an oral, extended release, abuse deterrent dosage form including (a) an active substance susceptible to abuse; (b) a controlled release agent such as a stearoyl polyoxylglyceride that has a melting temperature less than or equal to about 70° C.; and (c) a polyethylene glycol having an average molecular weight between about 3000 Daltons and about 4000 Daltons.

Active Substance Susceptible to Abuse

As used herein, the term “active substance” or “active substance susceptible to abuse” means any opioid or opioid related compound subject to potential abuse. The active substance may include, without limitation, alfentanil, allylprodine, alphaprodine, anileridine, benzylmorphine, bezitramide, buprenorphine, butorphanol, clonitazene, codeine, cyclazocine, desomorphine, dextromoramide, dezocine, diampromide, dihydrocodeine, dihydromorphine, dimenoxadol, dimepheptanol, dimethylthiambutene, dioxaphetyl butyrate, dipipanone, eptazocine, ethoheptazine, ethylmethylthiambutene, ethylmorphine, etonitazene, fentanyl, heroin, hydrocodone, hydromorphone, hydroxypethidine, isomethadone, ketobemidone, levallorphan, levophenacylmorphan, levorphanol, lofentanil, meperidine, meptazinol, metazocine, methadone, metopon, morphine, myrophine, nalbulphine, narceine, nicomorphine, norpipanone, opium, oxycodone, oxymorphone, papvretum, pentazocine, phenadoxone, phenazocine, phenomorphan, phenoperidine, piminodine, propiram, propoxyphene, sufentanil, tilidine, tramadol, tapentadol, and pharmaceutically acceptable salts and mixtures thereof.

In particular embodiments, the active substance can be hydrocodone or oxycodone.

The wt % of the active substance may vary depending on the active substance, stability, release profile and bioavailability. In some embodiments, the dosage form includes at least about 0.1 wt %, 0.2 wt %, 0.3 wt %, 0.4 wt %, 0.5 wt %, 0.6 wt %, 0.7 wt %, 0.8 wt %, 0.9 wt %, 1.0 wt %, 1.1 wt %, 1.2 wt %, 1.3 wt %, 1.4 wt %, 1.5 wt %, 2 wt %, 2.5 wt %, 3 wt %, 4 wt %, 5 wt %, 6 wt %, 7 wt %, 7.5 wt %, 8 wt %, 9 wt %, 10 wt %, 11 wt %, 12 wt %, 13 wt %, 14 wt %, 15 wt %, 16 wt %, 17 wt %, 18 wt %, 19 wt %, 20 wt %, 21 wt %, 22 wt %, 23 wt %, 24 wt %, 25 wt %, 26 wt %, 27 wt %, 28 wt %, 29 wt %, 30 wt %, 31 wt %, 32 wt %, 33 wt %, 34 wt %, 35 wt %, 36 wt %, 37 wt %, 38 wt %, 39 wt %, 40 wt %, 41 wt %, 42 wt %, 43 wt %, 44 wt %, 45 wt %, 46 wt %, 47 wt %, 48 wt %, 49 wt %, 50 wt %, 51 wt %, 52 wt %, 53 wt %, 54 wt %, 55 wt %, 56 wt %, 57 wt %, 58 wt %, 59 wt %, 60 wt %, 65 wt %, 69 wt %, 70 wt %, 75 wt %, 80 wt %, 85 wt %, 88 wt %, 90 wt %, or 95 wt % of the active substance. Any of these values may be used to define a range for the wt % of the active substance depending on the application. For example, the amount of active substance in the dosage form may range from about 0.10 wt % to about 60 wt %. Particularly, the amount of active substance in the dosage form may range from about 0.1 wt % to about 1.5 wt %, from about 5 wt % to about 30 wt %, from about 15 wt % to about 20 wt %, from about 15 wt % to about 30 wt %, from about 40 wt % to about 60 wt %, from about 40 wt % to about 50 wt %, or from about 42 wt % to about 46 wt %.

For example, the dosage form may be a 100 mg capsule including about 5 mg, about 10 mg, about 15 mg, about 20 mg, or about 30 mg of active substance (e.g. oxycodone HCl). In other embodiments, the dosage form may be a 150 mg capsule including about 5 mg, about 10 mg, about 15 mg, about 20 mg, about 30 mg, or about 45 mg of active substance (e.g. oxycodone HCl). In other embodiments, the dosage form may be a 200 mg capsule including about 5 mg, about 10 mg, about 15 mg, about 20 mg, about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg or about 80 mg of active substance (e.g. oxycodone HCl). In other embodiments, the dosage form may be a 250 mg capsule including about 2.5 mg, about 5 mg, about 7.5 mg, about 10 mg, about 15 mg, about 20 mg, about 30 mg, about 45 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg or about 100 mg of an active substance (e.g. oxycodone HCl). In other embodiments, the dosage form may be a 275 mg capsule including about 2.5 mg, about 5 mg, about 7.5 mg, about 10 mg, about 15 mg, about 20 mg, about 30 mg, about 45 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg or about 100 mg of an active substance (e.g. oxycodone HCl). In other embodiments, the dosage form may be a 500 mg capsule including about 2.5 mg, about 5 mg, about 7.5 mg, about 10 mg, about 15 mg, about 20 mg, about 30 mg, about 45 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg or about 100 mg of an active substance (e.g. oxycodone HCl). In other embodiments, the dosage form may be a 700 mg capsule including about 2.5 mg, about 5 mg, about 7.5 mg, about 10 mg, about 15 mg, about 20 mg, about 30 mg, about 45 mg, about 50 mg, about 60 mg, about 70 mg, about 80 mg, about 90 mg or about 100 mg of an active substance (e.g. hydrocodone).

Controlled Release Agent

The controlled release agent may include a compound selected from the group consisting of Compritol® ATO 888 (glyceryl behenate), Compritol® HD5 ATO (behenoyl polyoxylglycerides), Geleol™ mono and di glycerides(glycerol monostearate), and Gelucire® 33/01(glycerol esters of sat. C8-C18 fatty acids), Gelucire® 39/01 & 43/01 (glycerol esters of sat. C12-C18 fatty acids), Gelucire® 44/14 (lauroyl polyoxylglycerides/PEG-32 glyceryl laurate), Gelucire® 50/13 (stearoyl polyoxylglyceride), Gelucire® 53/10 (PEG-32 glyceryl stearate), Gelucire ® 62/02 (saturated polyglycolized glycerides), Precirol® ATO 5 (glycerol disterate/glyceryl palmitostearate), or Suppocire® pellets (hard fats).

The Gelucire® molecules are described utilizing a two part number: the first number indicates the melting temperature of the molecule; the second refers to the HLB number or Hydrophilic-Lipophilic Balance number which denotes if the molecule is hydrophobic or hydrophilic. This HLB number ranges from 0-14 with <10 being hydrophobic and >10 being hydrophilic. Hydrophilic molecules work through a swelling and disintegration mechanism of release whereas hydrophilic molecules work though erosion/diffusion. In certain embodiments the Gelucire® molecules used in this present disclosure are hydrophilic. In other embodiments, Gelucire® molecules used in this present disclosure are hydrophobic. In certain embodiments, a combination of hydrophobic and hydrophilic molecules are used.

The total wt % of the controlled release agent in the dosage form may vary depending on the active substance, stability, and release profile. In some embodiments, the controlled release agent is at least about 5 wt %, 10 wt %, 15 wt %, 20 wt %, 25 wt %, 30 wt %, 35 wt %, 36 wt %, 37 wt %, 38 wt %, 39 wt %, 40 wt %, 41 wt %, 42 wt %, 43 wt %, 44 wt %, 45 wt %, 46 wt %, 47 wt %, 48 wt %, 49 wt %, 50 wt %, 51 wt %, 52 wt %, 53 wt %, 54 wt %, 55 wt %, 56 wt %, 57 wt %, 58 wt %, 59 wt %, 60 wt %, 61 wt %, 62 wt %, 63 wt %, 64 wt %, 65 wt %, 66 wt %, 67 wt %, 68 wt %, 69 wt %, 70 wt %, 71 wt %, 72 wt %, 73 wt %, 74 wt %, 75 wt %, 76 wt %, 77 wt %, 78 wt %, 79 wt %, 80 wt %, 85 wt %, 88 wt %, 90 wt %, or 95 wt % of the dosage form. Any of these values may be used to define a range for the wt % of the controlled release agent in the dosage form. For example, in some embodiments, the wt % of the controlled release agent in the dosage form ranges from about 15 wt % to about 60 wt % or from about 30 wt % to about 40 wt %.

In certain embodiments, the controlled release agent has a melting temperature of about 100° C., 99° C., 98° C., 97° C., 96° C., 95° C., 94° C., 93° C., 92° C., 91° C., 90° C., 89° C., 88° C., 87° C., 86° C., 85° C., 84° C., 83° C., 82° C., 81° C., 80° C., 79° C., 78° C., 77° C., 76° C., 75° C., 74° C., 73° C., 72° C., 71° C., 70° C., 69° C., 68° C., 67° C., 66° C., 65° C., 64° C., 63° C., 62° C., 61° C., 60° C., 59° C., 58° C., 57° C., 56° C., 55° C., 54° C., 53° C., 52° C., 51° C., 50° C., 49° C., 48° C., 47° C., 46° C., 45° C., 44° C., 43° C., 42° C., 41° C., 40° C., 39° C., 38° C., 37° C., 36° C., 35° C., 34° C., 33° C., 32° C., 31° C. or 30° C. In certain embodiments, the controlled release agent has a melting temperature that is less than equal to about 100° C., 99° C., 98° C., 97° C., 96° C., 95° C., 94° C., 93° C., 92° C., 91° C., 90° C., 89° C., 88° C., 87° C., 86° C., 85° C., 84° C., 83° C., 82° C., 81° C., 80° C., 79° C., 78° C., 77° C., 76° C., 75° C., 74° C., 73° C., 72° C., 71° C., 70° C., 69° C., 68° C., 67° C., 66° C., 65° C., 64° C., 63° C., 62° C., 61° C., 60° C., 59° C., 58° C., 57° C., 56° C., 55° C., 54° C., 53° C., 52° C., 51° C., 50° C., 49° C., 48° C., 47° C., 46° C., 45° C., 44° C., 43° C., 42° C., 41° C., 40° C., 39° C., 38° C., 37° C., 36° C., 35° C., 34° C., 33° C., 32° C., 31° C. or 30° C. Any of these values may be used to define a range for the melting temperature of the controlled release agent. For example, the controlled release agent may have a melting temperature from about 90° C. to about 50° C. or from about 60° C. to about 40° C.

In one embodiment, the controlled release agent melts at a relatively low temperature under a process that incorporates as little oxygen as possible during melting and homogenization. For example, the stearoyl polyoxylglyceride requires a melting temperature of at least 70° C. with incorporation of as little oxygen as possible during melting and homogenization. The melted controlled release agent, and optionally the PEG, can create a suspension which incorporates other components of the dosage form, such as the second agent, which melts at a higher temperature.

Second Agent

The second agent may be selected from the group consisting of hydroxypropyl methylcellulose (HPMC), polyvinyl acetate, polyvinylpyrrolidone, cellulose ethers, cellulose esters, acrylic resins, and derivatives thereof, and combinations thereof. Particularly, the second agent may be selected from ethylcellulose, hydroxypropyl methylcellulose, hydroxypropylcellulose, hydroxymethylcellulose, poly(meth)acrylic acid, polyvinylpyrrolidone and derivatives thereof, such as the salts, amides or esters, and combinations thereof.

The total wt % of the second agent in the dosage form may vary depending on the active substance, stability, and release profile. In some embodiments, the second agent is at least about 5 wt %, 10 wt %, 15 wt %, 20 wt %, 25 wt %, 30 wt %, 35 wt %, 36 wt %, 37 wt %, 38 wt %, 39 wt %, 40 wt %, 41 wt %, 42 wt %, 43 wt %, 44 wt %, 45 wt %, 46 wt %, 47 wt %, 48 wt %, 49 wt %, 50 wt %, 51 wt %, 52 wt %, 53 wt %, 54 wt %, 55 wt %, 56 wt %, 57 wt %, 58 wt %, 59 wt %, 60 wt %, 61 wt %, 62 wt %, 63 wt %, 64 wt %, 65 wt %, 66 wt %, 67 wt %, 68 wt %, 69 wt %, 70 wt %, 71 wt %, 72 wt %, 73 wt %, 74 wt %, 75 wt %, 76 wt %, 77 wt %, 78 wt %, 79 wt %, 80 wt %, 85 wt %, 88 wt %, 90 wt %, or 95 wt % of the dosage form. Any of these values may be used to define a range for the wt % of the second agent in the dosage form. For example, in some embodiments, the wt % of the second agent in the dosage form ranges from about 5 wt % to about 60 wt % or from about 10 wt % to about 35 wt %.

In certain embodiments, the second agent has a melting temperature of about 100° C., 110° C., 120° C., 130° C., 135° C., 140° C., 145° C., 150° C., 155° C., 160° C., 165° C., 170° C., 180° C., 190° C., 200° C., 210° C., 220° C., 230° C., 240° C., 250° C., 260° C., 270° C., 280° C., 290° C., 300° C., 310° C., 320° C., 330° C., 340° C., 350° C., 360° C., 370° C., 380° C., 390° C., 400° C., 410° C., 420° C., 430° C., 440° C., 450° C., 460° C., 470° C., 480° C., 490° C., 500° C., 600° C., 700° C., 800° C., 900° C. or 1000° C. In certain embodiments, the second agent has a melting temperature greater than or equal to about 100° C., 110° C., 120° C., 130° C., 135° C., 140° C., 145° C., 150° C., 155° C., 160° C., 165° C., 170° C., 180° C., 190° C., 200° C., 210° C., 220° C., 230° C., 240° C., 250° C., 260° C., 270° C., 280° C., 290° C., 300° C., 310° C., 320° C., 330° C., 340° C., 350° C., 360° C., 370° C., 380° C., 390° C., 400° C., 410° C., 420° C., 430° C., 440° C., 450° C., 460° C., 470° C., 480° C., 490° C., 500° C., 600° C., 700° C., 800° C., 900° C. or 1000° C. Any of these values may be used to define a range for the melting temperature of the second agent. For example, the second agent may have a melting temperature from about 100° C. to about 200° C. or from about 135° C. to about 165° C.

In certain embodiments, the dosage form of the present disclosure does not include a second agent.

Polyethylene Glycol

The compositions of the present disclosure can also contain one or more polyethylene glycols. In some embodiments, the PEG has an average molecular weight of 3000, 3050, 3100, 3150, 3200, 3250, 3300, 3350, 3400, 3450, 3500, 3550, 3600, 3650, 3700, 3750, 3800, 3850, 3900, 3950 or 4000 Daltons. Any of these values may be used to define a range for the average molecular weight of the second PEG. For example, the PEG may have an average molecular weight between about 3100 Daltons and about 3900 Daltons, between about 3200 Daltons and about 3800 Daltons, between about 3300 Daltons and about 3700 Daltons, between about 3400 Daltons and about 3600 Daltons, between about 3000 Daltons and 3200 Daltons, between about 3200 Daltons and about 3400 Daltons, between about 3600 Daltons and about 3800 Daltons, or between about 3800 Daltons and about 4000 Daltons.

The total wt % of PEG in the dosage form may vary depending on the active substance, stability, and release profile. In some embodiments, the PEG is at least about 5 wt %, 10 wt %, 15 wt %, 20 wt %, 25 wt %, 30 wt %, 35 wt %, 36 wt %, 37 wt %, 38 wt %, 39 wt %, 40 wt %, 41 wt %, 42 wt %, 43 wt %, 44 wt %, 45 wt %, 46 wt %, 47 wt %, 48 wt %, 49 wt %, 50 wt %, 51 wt %, 52 wt %, 53 wt %, 54 wt %, 55 wt %, 56 wt %, 57 wt %, 58 wt %, 59 wt %, 60 wt %, 61 wt %, 62 wt %, 63 wt %, 64 wt %, 65 wt %, 66 wt %, 67 wt %, 68 wt %, 69 wt %, 70 wt %, 71 wt %, 72 wt %, 73 wt %, 74 wt %, 75 wt %, 76 wt %, 77 wt %, 78 wt %, 79 wt %, 80 wt %, 85 wt %, 88 wt %, 90 wt %, or 95 wt % of the dosage form. Any of these values may be used to define a range for the wt % of PEG in the dosage form. For example, in some embodiments, the wt % of PEG in the dosage form ranges from about 30 wt % to about 50 wt % or from about 20 wt % to about 60 wt %.

Dye

The composition can also include one or more dyes. A dye is useful in deterring abuse by discouraging the abuser from intravenous injection. For example, extraction of the dye along with the active ingredient would result in a colored solution that would discourage the abuser from intravenous injection. Thus, in certain embodiments, the dye reduces abuse by extracting and injecting. The dye may be selected from known dyes suitable for use in pharmaceutical formulations or approved by the FDA for such use. For example, the dye may be FD&C Blue No. 2 or a 50/50 Wt % solution of FD&C Blue No. 2 in PEG. In another embodiment, the dye may be a grey dye including FD&C Blue #1, FD&C Yellow #6, and FD&C Red #40. The dye may be in a 90% PEG 3350 blend. In certain embodiments, 14 mg of dye blend is used in each capsule or about 1.4 mg of concentrated dye. In certain embodiments a grey dye is used since it is visually deterring and non-transparent. The dosage form may include about 0.10 wt %, 0.20 wt %, 0.30 wt %, 0.40 wt %, 0.50 wt %, 1 wt %, 2 wt %, 3 wt %, 4 wt %, 5 wt %, 6 wt %, 7 wt %, 8 wt %, 9 wt %, 10 wt %, 11 wt %, 12 wt %, 13 wt %, 14 wt %, 15 wt %, 16 wt %, 17 wt %, 18 wt %, 19 wt %, or 20 wt % dye. Any of these values may be used to define a range for the wt % of the dye. For example, the dosage form may contain between about 0.10 wt % and about 15 wt % dye. Particularly, the dosage form may contain between about 0.20 wt % and about 1.5 wt % dye, about 0.50 wt % and about 1.0 wt % dye, or about 7 to about 14 wt % dye. In certain embodiments, the dosage form may include about 1 mg, 1.4 mg, 2 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7 mg, 8 mg, 9 mg, 10 mg, 11 mg, 12 mg, 13 mg, 14 mg, 15 mg, 16 mg, 17 mg, 18 mg, 19 mg, 20 mg, 21 mg, 22 mg, 23 mg, 24 mg, 25 mg, 26 mg, 27 mg, 28 mg, 29 mg or 30 mg of dye. In another embodiment, the dosage form of the present disclosure excludes a dye.

Other Excipients

The composition can also include a preservative or antioxidant. The preservative or antioxidant reduces or limits the degradation or deterioration of the abuse deterrent dosage form. The addition of a preservative or antioxidant in the dosage form may be necessary to prevent premature degradation of the active substance over the shelf life of the dosage form.

The preservative or antioxidant may be selected from preservatives or antioxidants known to one skilled in the art for use in pharmaceutical formulations, such as citric acid, ascorbic acid, ascorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene, erythorbic acid, hypophosphorous acid, lactobionic acid, monothioglycerol, potassium metabisulfite, propyl gallate, racemethionine, sodium bisulfite, sodium formaldehyde sulfoxylate, sodium metabisulfite, sodium sulfite, sodium thiosulfate, stannous chloride, sulfur dioxide and tocopherols. The formulation, or dosage form, may contain between about 0.1 wt % and about 2.0 wt %, or about 0.25 wt % and about 0.75 wt % of preservative or antioxidant. In another embodiment, the dosage form of the present disclosure excludes a preservative or antioxidant.

In some embodiments, the dosage form includes one or more excipients that form a gel in the presence of an alcohol. The alcohol gelling/thickening agent reduces or limits the potential for abuse by preventing extraction of the active substance from the dosage form. For example, when introduced to an alcohol solution, the components of the dosage form (e.g., active substances, stearoyl polyoxylglyceride, PEG, PVP) may become trapped in a gel/viscous liquid which prevents extraction and subsequent alcohol evaporation to produce a pure active substance. In one embodiment, the alcohol gelling/thickening agent does not form a gel in the presence of water. The dosage form may contain between about 0.1 wt % to 40 wt % alcoholic gelling/thickening agent. In another embodiment, the dosage form of the present disclosure does not contain an alcohol gelling/thickening agent.

The alcohol gelling/thickening agent may be a gelling or thickening agent known to one skilled in the art for use in pharmaceutical formulations, such as acacia, alginic acid, bentonite, calcium acetate, carbomers, carboxymethylcellulose, ethylcellulose, gelatin, hydroxyethylcellulose, hydroxypropyl cellulose, magnesium aluminum silicate, methylcellulose, poloxamers, polyvinylpyrrolidone, polyvinyl alcohol, polyvinyl acetate, sodium alginate, sorbitol derivatives, tragacanth, or xanthan gum.

The dosage form may additionally include at least one additive independently selected from surfactants, solubilizers, emulsifiers, bulking agents, poloxamers, lubricants, flavorings or combination thereof.

Abuse Deterrence

One of the most common means of abuse of an orally administered opioid analgesic involves the manipulation of the oral dosage form in order to achieve rapid delivery of the active substance from the dosage form. With regards to extended release formulations, abusers attempt to manipulate the dosage form to cause instantaneous release of the active substance originally intended to be delivered over 6-12 hours. This is a common method taken by abusers referred to as “dose dumping” which can be utilized through decreasing particle size or use of a solvent. Dose dumping results in a rapid release of higher than intended levels of active substance into the body, resulting in a euphoric high. In order for physical manipulation, such as chewing, grinding, or pulverizing, to be used as an effective means of abuse, the original dosage form must be manipulated so as to decrease the particle size of the drug which can be effectively insufflated and/or swallowed. Traditionally, decreasing the particle size of a dosage form will increase the rate of dissolution due to an increase of surface area on which a solution or solvent can act. One way to prevent abuse by physical manipulation is by capturing the active substance susceptible to abuse in a matrix which is dissolved at a similar rate regardless of particle size. This will inhibit abusers from achieving a euphoric high by limiting the amount of active substance available at one time. In some embodiments, the formulation of the present disclosure will maintain an extended release profile regardless of particle size. This delay in the rapid onset of active substance available is thought to decrease abuse by oral, intranasal, and intravenous pathways.

The dosage form of the present disclosure allows for manipulation by chewing, grinding or pulverizing using common equipment, such as a coffee grinder. For example, the formulation of the present disclosure contains no long chain polymers and as a result, can be easily ground into a powdered form. However, the formulation of the present disclosure deters abuse by limiting the amount of active substance available at one time regardless of particle size. The formulation prevents the active substance, or at least substantial portions of the active substance, from being immediately released when introduced to an aqueous environment. As a result, the dosage form is said not to be able to be prepared for abuse via swallowing or insufflation.

The dosage form of the present disclosure can also significantly limit the extraction of the active substance by common solvents (e.g., cold water or distilled aqueous ethanol) from the formulation. For example, the formulation deters abuse by limiting the ability of persons to extract the active substance from the dosage form (either intentionally or unintentionally), such that the active substance cannot easily be concentrated for parenteral administration. For example, if the dosage form is attempted to be extracted with alcohol or an aqueous solution, the stearoyl polyoxylglyceride, PVP, PEG and/or dye or combinations thereof will also be extracted and cannot be separated from the active substance, preventing the preparation of pure drug for intravenous administration. Extraction with a solution would result in a grey/black/brown liquid containing the stearoyl polyoxylglyceride, PVP, PEG, dye or combinations thereof, and the active substance. If an abuser tries to evaporate or burn off the liquid to form a powder, the stearoyl polyoxylglyceride and PEG melt before the alcohol and/or water evaporated, so that the extraction essentially becomes a melted wax with suspended API, which forms a solid once returned to room temperature. This prevents an abuser from separating out the extended release excipients and thereby, allows the dosage form to maintain an extended release profile. These properties allow for an oral drug delivery system that satisfies at least one of the categories in the FDA guidance (e.g., “physical and chemical barriers can change the physical form of an oral drug rendering it less amenable to abuse”). The abuse deterrent dosage form may also include, but does not require, the incorporation of other deterrents such as antagonists or irritants.

In one embodiment, the controlled release agent includes stearoyl polyoxylglyceride. The dosage form of the present disclosure can be rendered abuse deterrent by incorporating stearoyl polyoxylglyceride in the dosage form. The stearoyl polyoxylglyceride can deter extraction of the active substance with an alcohol in order to form a purified powder containing the active substance. For example, since stearoyl polyoxylglyceride melts and forms a wax before the alcohol burns off, an abuser may not be able to obtain a powder containing the active substance. The addition of a PEG to the dosage form may also deter abuse since it is soluble in water and alcohol and melts before either can be flashed off. Addition of a dye to the dosage form may result in a colored solution after extraction of the active substance, deterring intravenous injection. By varying the quantity of stearoyl polyoxylglyceride and/or PVP or PEG present within a dosage form, the characteristics of the dosage form can be manipulated in a way to create a wide array of abuse deterrent capsules having extended release profiles.

The controlled release agent, e.g. stearoyl polyoxylglyceride, can also be capable of allowing extended release of the active substance, providing abuse deterrence, and/or ensuring the formation of a solid dosage form that is stable at elevated temperatures, for example 40° C. The dosage form of the present disclosure can accomplish one or more of the above capabilities by using a mixture of a controlled release agent having a relatively low melting temperature, and a second agent having a relatively high melting temperature or a controlled release agent having a relatively low melting temperature, and/or a PEG. For example, the dosage form can include a controlled release agent having a melting temperature less than or equal to about 70° C., and a high molecular weight PVP or a controlled release agent that has a melting temperature less than or equal to about 70° C., and a PEG having an average molecular weight about 3000 Daltons and 4000 Daltons.

Extended Release

The abuse deterrent composition of the present disclosure is capable of extended release of the active substance. The dosage form may be manufactured to provide a composition exhibiting an extended release profile of at least one active substance. As used herein, “extended release” refers to a dosage form that releases the active substance or a pharmaceutically acceptable salt thereof, into the gastrointestinal tract of the user over a period of 6-12 hours. Particularly, the active substance is released continuously the period of 6-12 hours. In one embodiment, the amount of active substance released from the dosage form, e.g. oxycodone HCl, by exposure to simulated gastric fluid within 6-12 hours is about 85%. The formulation of the present disclosure exhibits an extended release profile that matches the reference listed drug for extended release active substance.

In different embodiments, the amount of active substance released from the dosage form by exposure to simulated gastric fluid, or other dissolution media known to one skilled in the art, is shown in Tables 1 and 2. The values in Tables 1 and 2 represent acceptable USP criterion and may differ from values associated with the RLD specifications. Each individual amount (approx. range) value for each column in Tables 1 and 2 (e.g., 1, 2, 3, 4, 5, 6 and 7) can be used with any other individual amount at other time points to define a release profile.

TABLE 1 Exemplary Release Profiles (e.g. 10, 20, 40, 80 mg active) 1 2 3 4 5 Time Amount Amount Amount Amount Amount (Hours) (approx. range) (approx. range) (approx. range) (approx. range) (approx. range) 1 22% and 28% 20% and 28%   22 and 30% 20% and 30% 20% and 40% 2 37% and 45% 35% and 45% 37% and 50% 35% and 50% 35% and 55% 4 58% and 72% 55% and 72% 58% and 75% 55% and 75% 55% and 80% 6 75% and 80% 70% and 80% 75% and 85% 70% and 85% 70% and 90% 8 NLT 75% NLT 75% NLT 80% NLT 80% NLT 85% 12 NLT 75% NLT 80% NLT 80% NLT 85% NLT 90%

TABLE 2 Exemplary Release Profile 6 7 (e.g., 10, 20 and 40 mg active) (e.g., 80 mg active) Time Amount Amount (Hours) (approx. range) (approx. range) 1 20% and 40% 25% and 45% 2 35% and 55% 45% and 65% 4 55% and 75% 65% and 85% 6 70% and 90% NLT 80% 8 NLT 80%

Process

In another embodiment, the present disclosure relates to a process for the production of an oral, extended release, abuse deterrent dosage form including preparing a homogenized suspension of at least one active substance susceptible to abuse, a controlled release agent, and a second agent and/or a PEG. The PEG can have an average molecular weight between about 3000 Daltons and about 4000 Daltons. The controlled release agent can have a melting temperature of less than or equal to 70° C. The second agent can have a melting temperature greater than or equal to 100° C. The process can further include dispensing the homogenized suspension into a capsule to produce the dosage form. In some embodiments, the capsule is formed by joining a capsule body with a capsule cap. In some embodiments of the processes described herein, the active substance is hydrocodone. In other embodiments, the active substance is oxycodone HCl. In certain embodiments, the abuse deterrent dosage forms of the present disclosure are capsules. The abuse deterrent dosage forms of the present disclosure may be produced by liquid filled encapsulation. Liquid filled encapsulation is a process in which active pharmaceutical ingredients are suspended or emulsified in a carrier matrix and filled into capsules. The capsules are usually made of hard gelatin or hydroxypropyl methylcellulose. One of the advantages of this dosage form is that it requires fewer excipients and processing steps than other traditional compressed solid dosage forms. The internal solid phase active pharmaceutical ingredient (e.g. oxycodone or hydrocodone) can be suspended in an external fluid phase. (e.g., a stearoyl polyoxylglyceride and/or PEG). In one embodiment, stearoyl polyoxylglycerides are used to liquid fill capsules because they are thermoplastics that melt at temperatures below the melting point of the hard gelatin capsule (<70° C.) and are solids at room temperature. If the filling material is liquid at room temperature, a banding process would need to follow. This process adds a gelatin band around the point where the two capsule ends join to create a unified capsule body to prevent any leakage. In some embodiments, the formulation of the present disclosure can include a band.

An exemplary liquid fill process is described. The liquid fill process can begin by dispensing excipients (e.g., stearoyl polyoxylglyceride, PVP, PEG and stabilizers/preservatives) and API according to theoretical percent weights of the final capsule fill weight. Following this step, the controlled release agent, e.g. stearoyl polyoxylglyceride pellets, can be added to a homogenizing mixing kettle which heats them above their melting point via jacketing on the kettle. When the controlled release agent, e.g. stearoyl polyoxylglyceride, is completely fluid, the API and other excipients can be mixed in to form a homogenized suspension. This occurs with the aid of mechanical agitation by way of several internal stirring arms and the homogenizer built into the kettle. Once a homogenized suspension is attained (newer kettles can be equipped with NIR probes to indicate when this occurs), the suspension can be pumped through jacketed hoses (to maintain the internal kettle temperature to prevent solidification in the hose) to a hopper on the capsule filling machine. An illustration of a capsule filling machine is provided in FIG. 1. The capsule filling hopper can also be jacketed to heat the suspension to prevent solidification. The capsule filling machine can contain a separate hopper which operators can fill with hard gelatin capsules. The hopper can feed into a rectifying drum which aligns all capsules in the same direction. Once aligned, the capsules sit vertically in a cap disk which allows for separation of the body and cap via vacuum. To fill the capsule, a positive displacement piston pump can be used to draw the product in from the jacketed hopper and dispense the suspension into the capsule body through a set of changeable nozzles. Fill weight adjustment can be achieved by varying the piston stroke of the pump. Changes can be made throughout the process due to accommodate frequent in-process capsule weight checks.

Once the capsule body is filled, the capsule body and cap can be joined via pusher pins which raise the capsule body upwards and into the capsule cap, which are held in place above the capsule body by a joining block. The pusher pins then push the unified capsule out of the cap disk and are discharged from the machine. The capsules are allowed to cool at room temperature on trays and are each weight checked via a capsule weigh checking machine. Following this, the capsules are then placed into a final output drum. Automatic capsule filling machines have the ability to produce 500 to 150,000 capsules an hour with a very high degree of accuracy.

In some embodiments, the present disclosure relates to a dosage form as described herein prepared by filling a capsule body with a heated homogenized suspension including an active substance, a controlled release agent, a second agent and/or a PEG. In some embodiments, the homogenized suspension including an active substance, a controlled release agent, and a second agent and/or a PEG wherein the suspension melts at a temperature of about 42° C., 43° C., 44° C., 45° C., 46° C., 47° C., 48° C., 49° C., 50° C., 51° C., 52° C., 53° C., 54° C., 55° C., 56° C., 57° C., 58° C., 59° C., 60° C., 61° C., 62° C., 63° C., 64° C., 65° C., 66° C., 67° C., 68° C., 69° C., 70° C., 71° C., 72° C., 73° C., 74° C., 75° C., 76° C., 77° C., 78° C., 79° C., 80° C., 81° C., 82° C., 83° C., 84° C., 85° C., 86° C., 87° C., 88° C., or 90° C. Any of these values may be used to define a range of melting temperatures for the homogenized suspension. For example, in certain embodiments, the homogenized suspension has a melting temperature between about 47° C. and about 52° C. In particular embodiments, the homogenized suspension including an active substance, a controlled release agent, a second agent and/or a PEG melts at temperatures below 77° C., i.e. the melting point of the hard gelatin capsule. In another embodiment, the present disclosure relates to a method of treating pain including administering to an individual in need thereof a therapeutically effective amount of a dosage form as described herein. The dosage form provides rapid onset of analgesia for the treatment of moderate to severe pain.

The disclosures of all cited references including publications, patents, and patent applications are expressly incorporated herein by reference in their entirety. Further, when an amount, concentration, or other value or parameter is given as either a range, preferred range, or a list of upper preferable values and lower preferable values, this is to be understood as specifically disclosing all ranges formed from any pair of any upper range limit or preferred value and any lower range limit or preferred value, regardless of whether ranges are separately disclosed. Where a range of numerical values is recited herein, unless otherwise stated, the range is intended to include the endpoints thereof, and all integers and fractions within the range. It is not intended that the scope of the invention be limited to the specific values recited when defining a range.

The present invention is further defined in the following Examples. It should be understood that these Examples, while indicating preferred embodiments of the invention, are given by way of illustration only.

EXAMPLES Example 1 Extended Release ADF Oxycodone Hydrochloride Liquid Fill Capsules with PEG

Extended release ADF Oxycodone Hydrochloride liquid fill capsules including stearoyl polyoxylglyceride or glycerol ester of sat. C12-18 fatty acids, and PEG 3350 were prepared and the release profiles of the oxycodone were determined. The capsules were prepared using the following exemplary procedure. Stearoyl polyoxylglyceride or glycerol ester of sat. C12-18 fatty acids, PEG 3350 and grey dye were placed in a 150 mL stainless steel cup on a hot plate, and allowed to melt completely under nitrogen blanket with no agitation, Once melted, citric acid and Oxycodone HCl (and other components, if present) were slowly added and mixed in. Once the necessary minimum melt temperature of 70° C. was achieved, the melt was homogenized using a Silverson homogenizer for a minimum of 10 minutes at setting 5 under a nitrogen blanket. Following homogenization, the melt was allowed to cool to <75° C. Capsules were hand filled to weight using a metal spatula. The melt was left on the hot plate to maintain liquid state. The filled capsules and remaining melt were allowed to cool and weights of good capsules and waste recorded. Table 3 list the formulations prepared.

TABLE 3 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Wt % Wt % Wt % Wt % Wt % Component 1 2 3 4 5 6 7 Oxycodone 5 20 40 40 40 40 29.63 Stearoyl 87 72 52 0 0 0 52 polyoxylglyceride glycerol ester of sat. 0 0 0 52 42 32 0 C12-18 fatty acids PEG 3350 0 0 0 0 10 20 12.19 Grey Dye Blend 7 7 7 7 7 7 5.18 Citric Acid 1 1 1 1 1 1 1 Active, mg 10 40 80 80 80 80 80 Capsule Fill Wt, mg 200 200 200 200 200 200 270

Dissolution Testing

The extended release ADF oxycodone hydrochloride liquid fill capsules in Table 3 were tested for dissolution. Dissolution testing was performed with reference to USP Monograph on Oxycodone Hydrochloride Extended-Release Tablets. These tests were performed on a dissolution apparatus utilizing UPS <711> Apparatus I (Baskets), with 900 mL Simulated Gastric Fluid (no enzymes) as media and a basket speed of 100 rpm. A 1.5 mL sample was pulled at each evaluated time point and submitted for HPLC analysis. HPLC conditions were modified from the USP monograph in order to observe the release of oxycodone HCl. The HPLC conditions were as follows: Injection Volume: 30 μL (oxycodone); Flow Rate 1.7 mL/min (oxycodone); Detection: UV at 225 nm (oxycodone); Column Temp: 25° C.; Autosampler Temperature: ambient; Gradient: Isocratic; and Runtime: 5 minutes. The specifications for dissolution testing are shown in Tables 1 and 2. The release profiles are shown in the Table 4.

TABLE 4 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules (Average of 3 capsules) Formulation 1 Hour 4 Hour 12 Hour 1 28.30 78.19 90.61 2 35.03 99.93 105.86 3 46.26 101.08 101.39 4 3.33 6.11 11.46 5 3.49 21.24 36.09 6 14.35 80.33 102.56 7 30.73 81.96 102.09

Example 2 Extended Release ADF Oxycodone Hydrochloride Liquid Fill Capsules with HPMC

Additional formulations containing HPMC in place of PEG were evaluated to determine the effect of HPMC on the active release profiles. The formulations were prepared using the same procedure of Example 1. The formulations are shown in Table 5. The release profiles are shown in the Table 6.

TABLE 5 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Wt % Wt % Wt % Wt % Component 8 9 10 11 12 13 Oxycodone 5 5 5 5.714 5.714 5.714 Stearoyl 82 77 72 85.286 85.286 85.286 polyoxylglyceride HPMC 5 10 15 0 5 10 Grey Dye Blend 7 7 7 8 8 8 Citric Acid 1 1 1 1 1 1 Active, mg 10 10 10 10 10 10 Capsule Fill Wt, mg 200 200 200 175 175 175

TABLE 6 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules (Average of 3 capsules) Formulation 1 Hour 4 Hour 12 Hour 8 28.41 71.53 91.56 9 25.85 57.03 92.41 10 24.64 56.08 95.97 11 26.93 72.39 89.98 12 25.62 68.55 89.14 13 24.65 55.14 95.20

Example 3 Extended Release ADF Oxycodone Hydrochloride Liquid Fill Capsules with HPMC and PEG 35,000

Additional formulations containing HPMC and PEG 35,000 were evaluated to determine the effect of HPMC and PEG 35,000 on release profiles. The formulations were prepared using the same procedure of Example 1. The formulations are shown in Table 7. The release profiles are shown in the Table 8.

TABLE 7 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Wt % Wt % Wt % Component 14 15 16 17 18 Oxycodone 5 5 5 5 5 Stearoyl 72 69.5 67 64.5 62 polyoxylglyceride HPMC 10 10 10 10 10 PEG 35,000 5 7.5 10 12.5 15 Grey Dye Blend 7 7 7 7 7 Citric Acid 1 1 1 1 1 Active, mg 10 10 10 10 10 Capsule Fill Wt, mg 200 200 200 200 200

TABLE 8 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules (Average of 3 capsules) Formulation 1 Hour 4 Hour 12 Hour 14 22.95 57.51 95.62 15 20.55 61.23 101.46 16 19.94 65.35 103.32 17 17.58 66.51 108.84 18 19.17 68.23 105.68

Example 4 Extended Release ADF Oxycodone Hydrochloride Liquid Fill Capsules with HPMC and PEG 3350

Additional formulations containing HPMC and PEG 3350 were evaluated to determine the effect of HPMC and PEG 3350 on release profiles. The formulations were prepared using the same procedure of Example 1. The formulations are shown in Table 9. The release profiles are shown in the Table 10.

TABLE 9 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Wt % Wt % Wt % Wt % Wt % Wt % Component 19 20 21 22 23 24 25 26 Oxycodone 5 5 5 5 5 5 5 5 Stearoyl 72 67 62 57 52 47 42 37 polyoxyl- glyceride HPMC 10 10 10 10 10 10 10 10 PEG 3350 5 10 15 20 25 30 35 40 Grey Dye 7 7 7 7 7 7 7 7 Blend Citric Acid 1 1 1 1 1 1 1 1 Active, mg 10 10 10 10 10 10 10 10 Capsule Fill 200 200 200 200 200 200 200 200 Wt, mg

TABLE 10 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules (Average of 3 capsules) Formulation 1 Hour 4 Hour 12 Hour 19 20.63 61.75 110.46 20 24.48 61.57 101.33 21 24.30 59.86 98.97 22 26.65 65.27 101.18 23 26.75 76.50 100.32 24 29.08 87.03 101.63 25 41.36 94.98 100.25 26 53.34 98.33 101.71

Example 5 Extended Release ADF Oxycodone Hydrochloride Liquid Fill Capsules with HPMC and PEG 3350

Additional formulations containing higher amounts of HPMC were evaluated to determine the effect of higher amounts of HPMC on release profiles. The formulations were prepared using the same procedure of Example 1. The formulations are shown in Table 11. The release profiles are shown in the Table 12.

TABLE 11 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Wt % Wt % Component 27 28 29 30 Oxycodone 5 5 5 5 Stearoyl 37 32 32 27 polyoxylglyceride HPMC 15 20 15 20 PEG 3350 35 35 40 40 Grey Dye Blend 7 7 7 7 Citric Acid 1 1 1 1 Active, mg 10 10 10 10 Capsule Fill Wt, mg 200 200 200 200

TABLE 12 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules (Average of 3 capsules) Formulation 1 Hour 4 Hour 12 Hour 27 26.54 66.50 104.11 28 27.86 67.73 100.10 29 32.88 74.41 98.08 30 29.06 75.94 103.35

Formulation 29 was further tested using the manufacturing process described in Example 1. The capsules were evaluated for dissolution to determine the effect of the formulations on oxycodone release profiles. The release profiles are shown in the Table 13.

TABLE 13 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules - Formulation 29 - (Average of 6 capsules) 10 mg ER Oxycodone Average 1 Hour Capsule 1 32.461 31.13267 Capsule 2 29.899 Capsule 3 32.632 Capsule 4 35.324 Capsule 5 29.656 Capsule 6 26.824 2 Hour Capsule 1 48.661 48.032 Capsule 2 46.852 Capsule 3 49.806 Capsule 4 51.354 Capsule 5 48.800 Capsule 6 42.716 3 Hour Capsule 1 61.805 63.325 Capsule 2 61.233 Capsule 3 63.324 Capsule 4 64.731 Capsule 5 62.759 Capsule 6 66.097 4 Hour Capsule 1 74.006 75.886 Capsule 2 74.172 Capsule 3 75.773 Capsule 4 76.900 Capsule 5 75.773 Capsule 6 78.689 12 Hour  Capsule 1 101.092 101.0475 Capsule 2 102.867 Capsule 3 93.646 Capsule 4 102.077 Capsule 5 101.977 Capsule 6 104.626

Table 14 provides exemplary formulations for 20 mg, 40 mg and 80 mg doses of oxycodone.

TABLE 14 Exemplary formulations of extended release 20 mg, 40 mg, and 80 mg ADF Oxycodone Hydrochloride liquid fill capsules Oxycodone stearoyl PEG Citric Grey Dye Capsule Oxycodone HCl polyoxylglyceride 3350 HPMC Acid Blend Fill Dose % % % % % % (mg) 20 mg 10.00 27.00 40.00 15.00 1.00 7.00 200.00 40 mg 16.00 19.90 42.50 15.00 1.00 5.60 250.00 40 mg 16.00 17.40 45.00 15.00 1.00 5.60 250.00 80 mg 16.00 30.20 40.00 10.00 1.00 2.80 500.00 80 mg 16.00 55.20 15.00 10.00 1.00 2.80 500.00

Example 6 Extended Release ADF Oxycodone Hydrochloride Liquid Fill Capsules with PVP or PEG 3350

Additional formulations containing PVP or PEG 3350 were evaluated to determine the effect on release profiles. The formulations were prepared using the same procedure of Example 1. The formulations are shown in Table 15. The release profiles are shown in the Table 16.

TABLE 15 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Wt % Wt % Component 31 32 33 34 Oxycodone 4 8 14.55 16 Stearoyl 69.40 65.40 66.86 45.20 polyoxylglyceride Kollidon 90F (PVP) 20 20 12.5 0 PEG 3350 0 0 0 35 Grey Dye Blend 5.6 5.6 5.09 2.8 Citric Acid 1 1 1 1 Active, mg 10 20 40 80 Capsule Fill Wt, mg 250 250 275 500

TABLE 16 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules (Average of 3 capsules) Formulation 1 Hour 2 Hour 4 Hour 6 Hour 8 Hour 31 27.58 42.61 63.78 79.89 90.85 32 26.53 40.68 62.25 78.84 90.42 33 27.24 42.55 65.88 84.16 93.75 Specification 20%-40% 35%-55% 55%-75% 70%-90% >85% (10, 20, 40 mg) 34 30.71 53.00 80.43 97.22 N/A Specification 25%-45% 45%-65% 65%-85% >85% N/A (80 mg)

The 10, 20, and 40 mg formulations of 31-33 are similar and contain a controlled release agent (e.g., stearoyl polyoxylglyceride) and a second agent (PVP). The second agent can also act to decrease purity since it can be soluble in both water and ethanol, as well as to slow dissolution in the presence of the controlled release agent. Kollidon 90F is a high molecular weight polyvinylpyrrolidone. The 90 is a nominal value that is a calculated by the manufacturer based on viscosity and molecular weight.

The 80 mg formulation contains only the controlled release agent and PEG 3350. The second agent was excluded because in order to reach a processable viscosity the fill weight had to be increased to 500 mg. In some embodiments, a processable viscosity is less than about 2500 cP at 75° C. measured using a Brookfield RVDV-II+ Pro digital viscometer equipped with a RV3 spindle at 50 RPM. This made the resulting capsule slug larger and delayed the release dramatically with the controlled release agent alone. The PEG was added to speed up the dissolution to achieve the necessary endpoints. The PEG also decreases the purity.

In other embodiments, a processable viscosity is less than about 2500, 2400, 2300, 2200, 2100, 2000, 1900, 1800, 1700, 1600, 1500, 1400, 1300, 1200, 1100, 1000, 900, 800, 700, 600 or about 500 cP at 75° C. measured using, for example, a Brookfield RVDV-II+ Pro digital viscometer equipped with a RV3 spindle at 50 RPM. These values can be used to define a range, such as between about 1500 and about 2000 cP at 75° C.

Example 7 Evaluation of Dyes

Numerous dyes were evaluated for their potential to deter intravenous abuse. Varying concentrations of FD&C Blue #2, green (FD&C Blue #2 and FD&C Yellow #5), FD&C Yellow #5, FD&C Red #40, and grey dye (FD&C Blue#1, FD&C Yellow #6, FD&C Red #40) were evaluated by dissolving them in a 95% ethanol 5% purified water (190 proof) solution and passing the solution through a syringe filter. After syringe filtering the dye solutions were visually evaluated for color intensity and rated on a scale of 0 to 5, with 0 indicating no color and 5 indicating dark, significant color. As shown in Table 15 below, the blue and green dyes exhibited the highest color intensity at low concentrations, e.g. 0.25% w/w. Solutions of grey dye before and after filtering are shown in FIGS. 2A and 2B, respectively. The grey dye was particularly striking and less appealing. An acceptable color scale designation after extraction of the dye is ≧4 on a scale of 1 to 5, with 5 being the highest level of color.

TABLE 17 Color intensity of dye solutions after syringe filtering Batch Dye Color Number Number Color Dye (% w/w) Dye (mg) Assignment* 66 Blue 0.25 1.75 4 67 Blue 0.50 3.50 5 68 Blue 0.75 5.25 5 69 Blue 1.00 7.00 5 70 Green 0.25 1.75 4 71 Green 0.50 3.50 4 72 Green 0.75 5.25 4 73 Green 1.00 7.00 4 74 Yellow 0.25 1.75 3 75 Yellow 0.50 3.50 4 76 Yellow 0.75 5.25 5 77 Yellow 1.00 7.00 5 78 Red 0.11 0.75 2 79 Red 0.21 1.50 3 80 Red 0.43 3.00 4 81 Red 0.63 4.44 5 82 Grey 0.25 1.75 2 83 Grey 0.50 3.50 2 84 Grey 0.75 5.25 4 85 Grey 1.00 7.00 4 86 Grey 2.00 14.00 5

Example 8 Abuse Deterrent Properties of Extended Release Liquid Fill Capsule Oxycodone Formulations

Grinding—The purpose of grinding or chewing an extended release dosage form is to break the extended release properties of the dosage form and cause the active substance to “dump” or be released in a relatively short amount of time. This is a common method of abuse since it requires little to no equipment to perform by an abuser. Once chewed or ground, the drug can be swallowed or insufflated for immediate release of the active substance.

The purpose of this study was to show that the contents of the capsule can maintain extended release properties and prevent dose dumping regardless of particle size in order to prevent abuse or misuse of the dosage form. The Retsch Knife Mill GRINDOMIX GM200 (TE96) was utilized to mimic a commercially available coffee grinder (Mr. Coffee) in order to grind the drug product from a capsule slug into a powder. The powder was then subjected to dissolution testing similar to that of the intact capsule. For the purposes of this study, any resulting powder which achieves a large increase (i.e., double that of the original intact formulation) in dissolution versus the intact capsule at the 1 or 2 hour mark is considered suitable for intranasal or oral abuse.

The Retsch Knife Mill GRINDOMIX GM200 utilizes a circular blade attachment to mimic commercially available coffee grinders. The GM200 has a top speed of 10,000 revolutions per minute (rpm), while commercially available coffee grinders have a top speed of approximately 20,000 rpm (an approximate two-fold increase in speed when comparing the GM200 to a Mr. Coffee grinder). However, the approximate two-fold increase in blade diameter (118 mm vs. 60 mm, when comparing the GM200 to a Mr. Coffee grinder, respectively) compensates for the approximate twofold decrease in top speed via the inversely proportional relationship of the two variables. Further, the torque provided by the GM200 is significantly higher than the torque provided by a Mr. Coffee grinder (0.860 Nm (Newton meters) of the GM200 vs. 0.062 Nm of the Mr. Coffee grinder, respectively), which additionally illustrates the ability (or lack thereof) of the Mr. Coffee grinder to modify the drug products into a particle size suitable for intranasal or oral abuse. The study evaluated the difference in dissolution of ground forms of several different formulations of oxycodone following modification (grinding) by the GM200.

Experimental: The following test equipment was used: Retsch Knife Mill GRINDOMIX GM200 (TE96). The following testing conditions were used: Analysis speed: 10,000 rpm; Analysis time: 30 seconds; The capsules, the formulations of which are listed in Table 18, are emptied prior to grinding (grinding the capsule in addition to the fill is unnecessary and not indicative of the pathway utilized by an abuser). Approximately 5.0 g of emptied capsules were used to create the powder. A tared empty capsule was then filled with the powder to +/−5 mg of the original intact capsule fill weight. Each sample was prepared in triplicate (N=3) and averaged to achieve a percent drug dissolved at a given time point. The results are shown in Table 19 and FIGS. 5-8.

TABLE 18 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Wt % Wt % Wt % Component 31 33 34 35 4-5 Oxycodone 4 14.55 16 16 29.09 Stearoyl 69.40 66.86 45.20 60.20 17.32 polyoxylglyceride glycerol ester of sat. 0 0 0 0 47.50 C12-18 fatty acids Kollidon 90F (PVP) 20 12.5 0 0 0 PEG 3350 0 0 35 20 0 Grey Dye Blend 5.6 5.09 2.8 2.8 5.09 Citric Acid 1 1 1 1 1 Active, mg 10 40 80 80 80 Capsule Fill Wt, mg 250 275 500 500 275

TABLE 19 Grinding data for the Extended Release Liquid Fill Capsule Oxycodone Formulations Batch Potency Intact/Ground 1 h 2 h 4 h 6 h 8 h 35 80 mg Intact 28 51 80 97 N/A Ground 51 78 99 100 Difference 23 27 20 2 34 80 mg Intact 23 40 61 77 N/A Ground 37 59 88 100 Difference 14 19 26 23 31 10 mg Intact 27 41 62 79 90 Ground 37 58 82 93 96 Difference 11 17 19 14 5 33 40 mg Intact 27 43 66 84 94 Ground 39 61 87 97 99 Difference 12 19 21 13 5

As shown in Table 19 and FIG. 5-8, the ground capsule does slightly increase the rate of dissolution. The active substance, however, does not “dump” because the increase is less than a 2 fold increase in the early time points (e.g. 1 h and 2 h). The ground formulations still maintain an sustained release profile. The dosage form has a deterrent to abuse at least by physical manipulation such as chewing, grinding, or pulverization.

Extraction—Color is one identifying characteristic of commercial drug products. Color can be applied to the dosage form in two ways: dye or coating. High potency alcohol (i.e., ≧190 proof (95%)) is one extraction solvent that can be used by abusers for APIs which are insoluble in water or in order to separate the API from other water soluble excipients. Dyes or coatings can potentially be used to alter the physical appearance of the extracted solution of drug product (i.e., turn the resulting solution a noticeable color).

Accordingly, the inclusion of one or more dyes in a drug formulation is one method to render a formulation abuse deterrent. Significant discoloration of an extraction product from a formulation subject to abuse can discourage a potential abuser from using (e.g., injecting or ingesting) the extraction product.

A study is conducted to investigate the effect of dyes in the formulations of the present disclosure. Extraction products from whole formulations are visually inspected to determine abuse deterrence following alcohol extraction. Capsules are added to a flask containing 190 proof ethanol and shaken at 250 rpm for 3 hours. After 3 hours all capsule contents are fully dissolved. Solutions are filtered with a syringe filter and then visually analyzed for color intensity. FIGS. 3 and 4 show exemplary results of the tests.

The amount of dye present in the formulation can be an amount that produces an extract or a filtered extract using water, alcohol or a combination of both with a color that is greater than 0, or greater than 1, or greater than 2, or greater than 3 or greater than 4 on the visual scale disclosed, or similar scale. The amount of dye can vary depending on the formulation and components present. In some embodiments, the formulation can contain at least 0.1% dye, at least 0.2% dye, at least 0.3% dye, at least 0.4% dye, at least 0.5% dye, at least 0.6% dye, at least 0.7% dye, at least 0.8% dye, at least 0.9% dye, at least 1.0% dye, at least 1.5% dye, at least 2.0%, at least 3.0%, at least 4.0%, at least 5.0%, at least 6.0%, at least 7.0%, at least 8.0%, at least 9.0%, at least 10.0%, at least 11.0%, at least 12.0%, at least 13.0%, at least 14.0%, or any range of these values (e.g. between about 0.1% and about 1.0% dye).

Purity of the dosage form attainable in 190 proof ethanol and water was also tested. Additional formulations containing Gelucire® 50/13 (stearoyl polyoxylglyceride) were evaluated to determine the effect of the components on purity of the extractable API. The formulations were prepared using the same procedure of Example 1. The formulations are shown in Table 19 & 22. The purity data is shown in Tables 20 and 21. The composition of the present disclosure can reduce or minimize the purity of the resulting API extracted from the composition with alcohol, water or combinations thereof to a purity less than about 75%, 70%, 65%, 60%, 55%, 50%, 45%, 40%, 35%, 30%, 25%, 20%, 15%, or about 10%. These values can also define a range, such as about 20% to about 50%.

TABLE 20 Purity data for the Extended Release Liquid Fill Capsule Oxycodone Formulations % LC Water Passes Ethanol 25° C. Batch Potency Dissolution Notes 25° C. 70° C. 90° C. 25° C. 5° C. (pH 1.2) 36 40 No Gelucire ® 50/13 14 N/A 96 30 27 26 no PVP 33 40 Yes Gelucire ® 50/13 26 108 177 62 42 56 PVP (12.5% w/w) 47 80 Yes Gelucire ® 50/13 10 N/A 94 73 58 52 & 43/01 1 hour, unagitated, 5 mL/dosage unit

TABLE 21 Purity data for the Extended Release Liquid Fill Capsule Oxycodone Formulations % Purity Water Passes Ethanol 25° C. Batch Potency Dissolution Notes 25° C. 70° C. 90° C. 25° C. 5° C. (pH 1.2) 36 40 No Gelucire ® 50/13 9 N/A 15 23 25 20 no PVP 33 40 Yes Gelucire ® 50/13 10 13 15 21 20 14 PVP (12.5% w/w) 47 80 Yes Gelucire ® 50/13 27 N/A 50 61 57 56 & 43/01 Evaporated residue

In some embodiments, the formulation is homogenous and does not undergo any visible phase separation after all of the formulation components are combined. For example, in a formulation containing two components having drastically different HLB numbers, a visible phase separation between two portions of the formulation can occur. When a visible phase separation occurs, the formulation is no longer homogenous. A non-homogeneous formulation can result in a non-homogeneous dosage form. Similarly, a visible phase separation can also occur when the formulation has a high content of non-melting components. In formulations that cannot form a single phase, e.g., formulations that becomes saturated to the point of which the melt becomes a viscous paste, the formulation is no longer homogeneous. For example, formulations containing over 10% of PEG 35K can become non-homogenous.

Example 9 Extended Release ADF Oxycodone Hydrochloride Liquid Fill Capsules with Stearoyl Polyoxylglyceride

Additional formulations containing stearoyl polyoxylglyceride were evaluated to determine the effect on release profiles. The formulations were prepared using the same procedure of Example 1. The formulations are shown in Table 22. The release profiles are shown in the Table 23.

TABLE 22 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Component 36 47 Oxycodone 14.55 29.09 Stearoyl 79.36 17.32 polyoxylglyceride Glycerol esters of sat. 0 47.5 C12-C18 fatty acids Kollidon 90F (PVP) 0 0 PEG 3350 0 0 Grey Dye Blend 5.09 5.09 Citric Acid 1 1 Active, mg 40 80 Capsule Fill Wt, mg 275 275

TABLE 23 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules (Average of 3 capsules) Formulation 1 Hour 2 Hour 4 Hour 6 Hour 8 Hour 36 25.98 43.93 72.57 88.49 95.55 47 33.12 49.33 70.47 84.19 N/A

Example 10 Extended Release ADF Oxycodone Hydrochloride Liquid Fill Capsules with HPMC and PEG 3350

Additional formulations containing stearoyl polyoxylglyceride, HPMC and PEG 3350 were evaluated to determine the effect on release profiles. The formulations were prepared using the same procedure of Example 1. The formulations are shown in Table 24. The release profiles and viscosity are shown in the Tables 25 and 26.

TABLE 24 Oxycodone Hydrochloride liquid fill capsules. Wt % Wt % Wt % Wt % Wt % Wt % Wt % Wt % Wt % Wt % Component 37 38 39 40 41 42 43 44 45 46 Oxycodone 5 5.405 16.00 14.55 14.55 14.55 16.00 16.00 16.00 16.00 Stearoyl 32 31.97 62.91 69.42 64.41 59.42 70.20 60.20 50.20 40.20 polyoxylglyceride HPMC 15 16.22 0 0 0 0 0 0 0 0 Kollidon 90F (PVP) 0 0 15.0 12.49 12.49 12.49 0 0 0 0 PEG 3350 40 37.84 0 0 5.0 10.0 10.0 20.0 30.0 40.0 Grey Dye Blend 7 7.565 5.09 2.55 2.55 2.55 2.80 2.80 2.80 2.80 Citric Acid 1 1 1 1 1 1 1 1 1 1 Active, mg 10 10 80 80 80 80 80 80 80 80 Capsule Fill Wt, mg 200 185 500 550 550 550 500 500 500 500

TABLE 25 Dissolution testing of Oxycodone Hydrochloride liquid fill capsules (Average of 3 capsules) Formulation 1 Hour 2 Hour 3 Hour 4 Hour 12 Hour 37 31.133 48.032 63.325 75.886 101.048 38 30.159 47.992 61.080 N/A N/A

TABLE 26 Viscosity of Oxycodone Hydrochloride liquid fill capsules % Non- Viscosity % Melting Melting (cP) Formulation Potency (mg) Components Components @ 75° C. 31 10 75.00 25.00 1190 32 20 71.00 29.00 1490 33 40 71.96 28.04 1640 34 80 83.00 17.00 408 35 80 83.00 17.00 342 37 10 79.00 21.00 1520 38 10 77.38 22.62 2080 39 80 68.00 32.00 4010 40 80 71.96 28.04 1805 41 80 71.96 28.05 1910 43 80 83.00 17.00 465 45 80 83.00 17.00 502 46 80 83.00 17.00 520

The % Melting Components refers to the components that melt at a relatively low temperature, such as below about 70° C. (or as otherwise provided herein), and can include the controlled release agent, PEG, and dye blend. The % Non-Melting Components refers to the components that melt at a relatively higher temperature, such as above about 70° C. (or as otherwise provided herein), and can include the API, HPMC and PVP. 

We claim:
 1. An extended release, abuse deterrent capsule comprising: (a) an active substance susceptible to abuse; (b) a controlled release agent that has a melting temperature less than or equal to about 70° C.; and (c) a second agent that has a melting temperature greater than or equal to about 100° C., or (d) a polyethylene glycol having an average molecular weight between about 3000 Daltons and about 4000 Daltons.
 2. The capsule of claim 1 comprising an active substance susceptible to abuse; a controlled release agent that has a melting temperature less than or equal to about 70° C.; and a second agent that has a melting temperature greater than or equal to about 100° C.
 3. The capsule of claim 1 comprising an active substance susceptible to abuse; a controlled release agent that has a melting temperature less than or equal to about 70° C.; and a polyethylene glycol having an average molecular weight between about 3000 Daltons and about 4000 Daltons.
 4. The capsule of claim 1, wherein the controlled release agent is selected from the group consisting of glyceryl behenate, behenoyl polyoxylglycerides, glycerol monostearate, glycerol esters of sat. C8-C18 fatty acids, glycerol esters of sat. C12-C18 fatty acids, lauroyl polyoxylglycerides/PEG-32 glyceryl laurate, stearoyl polyoxylglyceride, PEG-32 glyceryl stearate, saturated polyglycolized glycerides, glycerol disterate/glyceryl palmitostearate, and hard fats.
 5. The capsule of claim 1, wherein the second agent is selected from the group consisting of hydroxypropyl methylcellulose, polyvinyl alcohol, polyvinylpyrrolidone, cellulose ethers, cellulose esters and acrylic resins.
 6. The capsule of claim 1, wherein the controlled release agent is stearoyl polyoxylglyceride.
 7. The capsule of claim 1, wherein the second agent is polyvinylpyrrolidone.
 8. The capsule of claim 1, wherein the controlled release agent is from about 15 wt % to about 70 wt % of the capsule.
 9. The capsule of claim 1, wherein the second agent is from about 5 wt % to about 20 wt % of the capsule.
 10. The capsule of claim 1, wherein the polyethylene glycol is from about 10 wt % to about 40 wt % of the capsule.
 11. The capsule of claim 1, wherein the active substance is hydrocodone.
 12. The capsule of claim 1, wherein the active substance is oxycodone HCl.
 13. The capsule of claim 1, wherein the active substance is oxymorphone HCl.
 14. The capsule of claim 1, wherein the active substance is hydromorphone HCl.
 15. The capsule of claim 1, further comprising a dye.
 16. The capsule of claim 15, wherein the dye comprises FD&C Blue #1, FD&C Yellow #6, and FD&C Red #40.
 17. The capsule of claim 15, wherein the dye reduces abuse via extracting and injecting.
 18. The capsule of claim 1, wherein the capsule comprises at least about 2.5 wt % of the active substance.
 19. The capsule of claim 1, wherein the capsule is prepared by filling a capsule body with a heated homogenized suspension comprising the active substance, the controlled release agent, the second agent or the polyethylene glycol.
 20. The capsule of claim 1, wherein the capsule comprises about 10 mg, about 20 mg, about 40 mg, or about 80 mg of the active substance, and exhibits an extended release of the active substance.
 21. The capsule of claim 1, wherein the contents of the capsule are solid at 40° C./75% relative humidity.
 22. A process for the production of an extended release, abuse deterrent capsule comprising at least one active substance susceptible to abuse comprising: (a) preparing a homogenized suspension of: (i) the at least one active substance susceptible to abuse; (ii) a controlled release agent that has a melting temperature less than or equal to about 100° C.; and (iii) a second agent that has a melting temperature greater than or equal to about 100° C.; or (iv) a polyethylene glycol having an average molecular weight between about 3000 Daltons and about 4000 Daltons; and (b) dispensing the homogenized suspension into a capsule body to produce the capsule.
 23. The process of claim 22, wherein the controlled release agent is stearoyl polyoxylglyceride.
 24. The process of claim 22, wherein the second agent is polyvinylpyrrolidone.
 25. The process of claim 22, wherein the active substance is hydrocodone.
 26. The process of claim 22, wherein the active substance is oxycodone HCl.
 27. The process of claim 22, wherein the active substance is oxymorphone HCl.
 28. The process of claim 22, wherein the active substance is hydromorphone HCl.
 29. The process of claim 22, wherein the capsule is formed by joining a capsule body with a capsule cap.
 30. A method of treating pain comprising administering to a subject in need thereof a therapeutically effective amount of the capsule of claim
 1. 